In:
BJU International, Wiley, Vol. 95, No. 6 ( 2005-04), p. 761-765
Abstract:
To assess the utility of prostate‐specific antigen (PSA) complexed to α1‐antichymotrypsin (PSA‐ACT) in prostate cancer screening in Japanese men with a total PSA level of 2.0–4.0 ng/mL, as improving cancer detection in men with these total PSA levels is a challenge for clinical urologists. PATIENTS AND METHODS Total PSA and PSA‐ACT were prospectively assessed and prostate biopsy recommended for patients who met either of two thresholds, i.e. a total PSA of ≥ 2.0 ng/mL or a PSA‐ACT of ≥ 1.5 ng/mL. The diagnostic ability of total PSA and PSA‐ACT, and free‐to‐total PSA ratio and prostate volume‐adjusted density were evaluated by receiver operating characteristic (ROC) analysis. RESULTS Of 1003 men enrolled, 547 met the biopsy criteria and a biopsy was taken in 315 (57.6%) patients. The area under the ROC curve for PSA‐ACT (0.679) was significantly greater than that for total PSA (0.601, P = 0.04) and equivalent to that for the free‐to‐total ratio (0.686, P = 0.911) in 116 men, including 27 with cancer with total PSA levels of 2.0–4.0 ng/mL. PSA‐ACT was more specific than the free‐to‐total ratio at a sensitivity of 95% (36% vs 18%, P 〈 0.05). The best variable for discriminating between cancer and benign disease in men with PSA levels of 2.0–4.0 ng/mL was PSA‐ACT density (area under the curve 0.852) which provided 66% specificity at a sensitivity of 90%. CONCLUSIONS PSA‐ACT is better than total PSA and equivalent to the free‐to‐total ratio for detecting prostate cancer in men with PSA levels of 2.0–4.0 ng/mL, and is thus useful for reducing the number of unnecessary biopsies.
Type of Medium:
Online Resource
ISSN:
1464-4096
,
1464-410X
DOI:
10.1111/bju.2005.95.issue-6
DOI:
10.1111/j.1464-410X.2005.05396.x
Language:
English
Publisher:
Wiley
Publication Date:
2005
detail.hit.zdb_id:
2019983-1
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